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The research was commissioned by HSE in response to an increase in the numbers of people suffering with anxiety and depression in recent years, leading to widespread use of medication to treat these conditions. These drugs have known side effects that include further anxiety, sleep disruption, tiredness, fatigue, nausea and headaches.

The study, conducted by the Health and Safety Ergonomics Unit, Loughborough University, the Department of Health and Social Care, Brunel University, examined how the drugs used to treat anxiety and depression affect performance and safety at work.

The research found:

Anxiety, depression and the medication prescribed by doctors to treat these conditions appear to affect work performance. Sufferers described a variety of accidents and near misses believed to be due to their condition or the side effects of medication.

Workers with responsibilities for others, such as teachers, doctors or managers seem to present a particular risk to safety in the workplace. For example, doctors described situations in which they may have placed themselves and their patients at risk when making clinical decisions or carrying out medical procedures such as taking blood samples. Electricians and mechanics described how they had to repeatedly check their work, as they were aware that they could endanger lives.

The researchers talked to groups of employees who had suffered anxiety and depression. The data collected included personal experiences of mental health problems and the impact of their medication. Focus groups were also held with managers from human resources and occupational health and safety departments to explore employers' views and practices in connection with mental health among their employees. The study covered a wide range of work sectors, including health care, social services, education, manufacturing, engineering, retail and service industries.

Employees admitted that failure to take prescribed medications was commonplace, due to unpleasant side effects, lack of improvement of symptoms or because the medication made people feel worse at first. Employees said they were often unprepared for the effects of their medication and would have welcomed better information from doctors and pharmacists. The researchers also found that mental health problems are not well understood by employers and managers, with little support in the workplace for individuals suffering from anxiety or depression.

"People suffering with anxiety and depression experience great difficulties at work managing their symptoms and dealing with unpleasant side effects of their medication," said the lead researcher, Professor Cheryl Haslam. "Many were unprepared for the fact that it can take two or three weeks before they see improvement in their symptoms after starting medication. Patients need more information about the medication and side effects, so they know what to expect."

The report makes recommendations for the prevention and management of anxiety and depression in the workplace, as well as outlining areas for improvement in health care.

Medications prescribed for anxiety and depression included selective serotonin reuptake inhibitors (e.g. Prozac or Seroxat), benzodiazepines (e.g. Valium or Ativan) and other anti-depressant or anti-manic pharmaceuticals.

Copies of "Effects of prescribed medication on performance in the working population", RR 057 (ISBN 0 7176 2595 8), can be ordered online at www.hsebooks.co.uk.